If you need more coverage than what you get from Original Medicare alone, you can get extra protection from Medicare Supplement Insurance. Two of the most popular Medicare Supplement (or Medigap) plans are Plan G and Plan F. They both provide broad coverage, but they are not identical. To figure out if one of these is right for you depends on your eligibility, budget, health, and other personal needs.
Availability of Medicare Supplement plans
A big difference between these plans is their enrollment requirements. Plan G is available to anyone who is eligible to enroll in Medicare, but Plan F is limited – it is no longer available for newly-eligible beneficiaries. However, you can still be “grandfathered” into the plan if you were eligible for Medicare before January 1, 2020.
If you were not eligible for Medicare until 2020 or after, the choice between the two plans is easy. Plan G is your only option. Those who were eligible for Medicare before 2020 might be tempted to pick Plan F simply because it seems exclusive, but it’s important to carefully review all of your coverage options.
Types of coverage available with Medicare Plan F vs Plan G
The main thing to think about when deciding between Medicare Supplement plans is the coverage they offer. This will help you determine whether the plan has the services you need.
First, let’s take a look at what both plans cover. Neither plan has an out-of-pocket limit, and both Plan F and Plan G have coverage for the following:
- Part A deductible, coinsurance, and any hospital costs
- Part A hospice care copayments and coinsurance
- Part B coinsurance and copayments
- Part B excess charges
- First three pints of blood
- 80% of the billed charges for certain medically necessary emergency care outside the U.S.
- Coinsurance for skilled nursing facilities
The difference between Plan F and Plan G is that Plan G does not cover the deductible payments for Medicare Part B (Plan F does, which is why it was discontinued). The deductible amount changes every year and you can view the most recent deductible costs in the table below.
| Part B Costs | What You Pay in 2024 |
|---|---|
| Premium | $174.70 each month, but may be higher based on your income. This does not include any potential penalty if you don’t sign up for Medicare Part B when you’re first eligible. |
| Deductible | $240 before Original Medicare starts to pay. |
| General costs for services (Coinsurance) | 20% (usually) for each Medicare-covered service after you’ve paid your deductible (and your doctor accepts assignments). |
| Clinical laboratory services | $0 for covered services |
| Home health care | $0 for covered home health services. 20% of the Medicare-approved cost for durable medical equipment. |
| Inpatient hospital care | 20% of the Medicare-approved amount |
| Outpatient mental health care | $0 for yearly depression screening // 20% of the Medicare-approved amount for doctor or health-care provider visits for diagnosis or treatment. Services rendered in a hospital outpatient clinic or department may result in an additional amount paid to the hospital. |
| Partial hospitalization mental health care | After you meet the Part B deductible, it is 20% of the Medicare-approved amount for each covered service. You may have to pay coinsurance for each day of partial hospitalization. |
| Outpatient hospital care | Usually 20% of the Medicare-approved amount for covered services. |
Costs for your Medigap premiums
While Medicare Plan G offers slightly less out-of-pocket coverage than Plan F, this does not automatically mean that Plan F is better. If you’re on a budget, monthly premium amounts tend to be a major consideration. Since Plan G has less coverage, its premiums tend to be less expensive.
Keep in mind that when you compare Medicare Supplement plans, you need to consider both the cost of premiums and the cost of future health care bills. If you don’t often use Part B, having a lower monthly premium with Plan G can save you money overall. However, if you use your Medicare Part B frequently, the costs not covered by Plan G can quickly add up. Paying a little more upfront for your Medicare Supplement plan might save you in the long run.
Is Medicare Plan G or Plan F right for you?
Still not sure which Medicare Supplement plan is right for you? We can help. Our Licensed Insurance Advisors take the time to learn about your health care needs and offer personalized recommendations for you. Give us a call at (855) 665-9200 or visit our Plan Comparison tool to get started.
